title: The use of short segment free jejunal transfer as salvage surgery for cervical esophageal and hypopharyngeal cancer.
abstract: BACKGROUND
  Salvage surgery after definitive chemoradiotherapy for cervical esophageal cancer and hypopharyngeal cancer remains a challenge because of the high rate of complications. The purpose of this study was to evaluate the safety and efficacy of free jejunal transfer as salvage surgery for cervical esophageal cancer and hypopharyngeal cancer after definitive chemoradiotherapy.
  
  
  METHODS
  We enrolled eight patients with cervical esophageal cancer and 11 patients with hypopharyngeal cancer who underwent free jejunal transfer as salvage surgery following radiotherapy or chemoradiotherapy. In this study, we reviewed the surgical procedures, perioperative complications, and survival rates.
  
  
  RESULTS
  The median duration of surgery was 514 min, and the median blood loss was 439 ml. In surgical procedures, the recipient vessels for the anastomosis of the free jejunum consisted of one artery and one vein (63 %), one artery and two veins (5 %), and two arteries and two veins (31 %). The postoperative morbidity rate was 57.9 % (11 patients), with six cases of partial necrosis of the tracheal margin and no cases of graft necrosis or postoperative in-hospital death. The overall 5-year survival rate after surgery was 58.1 %.
  
  
  CONCLUSIONS
  Our findings suggest that with careful attention to the potential development of necrosis of the tracheal margin, pharyngolaryngoesophagectomy and free jejunal transfer can be safely performed, even in patients who received radiotherapy or chemoradiotherapy.
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan, smayanagi@hotmail.com.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Mayanagi
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Onitsuka
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsubosa
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007583:Jejunum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D009333:Neck; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*